386P - Efficacy of anlotinib in posterior line treatment of locally advanced and metastatic NSCLC with KRAS mutation

Background

This study aims to observe and evaluate the clinical efficacy, safety and prognostic factors of anlotinib versus traditional chemotherapy for locally advanced and metastatic NSCLC with KRAS mutation that failed in first-line treatment, in order to explore more effective therapy.

Methods

We conducted a retrospective analysis of 100 patients pathologically confirmed with locally advanced and metastatic NSCLC who had previously failed first-line therapy from January 2018 to June 2020. KRAS mutation was detected by second-generation sequencing.There were 50 patients in the anlotinib group (including monotherapy and combination therapy) and 50 patients in the traditional chemotherapy group.Follow-up data were available until June 2022.The ORR, DCR, mPFS and mOS were statistically analyzed，adverse events(AE) was mainly descriptive.

Results

Firstly, the baseline characteristics of clinical data in anlotinib group and chemotherapy group were analyzed, and there was no difference between the groups (P>0.05).Efficacy and survival data are shown in the table. Adverse reactions: The most common AEs in the anlotinib group were hypertension (30.0%), fatigue (20.0%), digestive system reaction (18.0%), etc. The most common AEs in chemotherapy group were myelosuppression (30.0%), digestive system reaction (28.0%), fatigue (24.0%), etc. The adverse reactions were alleviated after active symptomatic treatment and drug reduction, and no death occurred. In univariate analysis, the patients with ECOG score (0-1), no bone metastasis and second-line treatment had significant benefits of PFS and OS. Multivariate analysis showed that treatment lines and treatment regimen may be one of the independent factors of PFS, while ECOG score and treatment lines may be the independent factors of OS. Table: 386P

Conclusions

For the posterior line treatment of the patients with KRAS-mutant locally advanced and metastatic NSCLC, anlotinib was superior to the traditional chemotherapy in terms of ORR, DCR, mPFS with less toxicity and better safety. Unfortunately, although this study also included people who received immunotherapy (30 cases), the endpoint of the study was not reached due to the late initiation of drug use. The data of the immunotherapy group are expected to be updated and released in the future.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

Cancer Hospital affiliated to Harbin Medical University.

Funding

Has not received any funding.

Disclosure

The author has declared no conflicts of interest.